title: Objective assessment of pain-related stress in mechanically ventilated newborns based on skin conductance fluctuations.
abstract: BACKGROUND
  In the process of intensive care, neonates are exposed to stress and pain related to the repeated therapeutic- diagnostic procedures. The aim of this study was the objective assessment of stress intensity pain while performing selected procedures in neonates in the intensive care unit.
  
  
  METHODS
  32 neonates, with a mean body mass of 2,495 g, intubated and mechanically ventilated, and who underwent sedation and analgesia were qualified to the study. A stress reaction to suctioning from endotracheal tube and capillary blood taking for blood gas analysis was evaluated. For the pain stress evaluation, the conductance fluctuation method was used.
  
  
  RESULTS
  0.20 oscillations per second during the mechanical ventilation were obtained; during the suctioning, the number of oscillations increased to 0.33. With finger tip puncture, the number of oscillations was 0.35. The mean values obtained in the cases of suctioning and puncture differed significantly from the ones obtained at mechanical ventilation (P < 0.001) and did not differ between one another (P = 0.558). The oscillation proportion ≥ 0.33 s-1 was the lowest during the ventilation and it was significantly different (P < 0.001) from the values obtained at suctioning and finger tip puncture. There were no significant differences between these values.
  
  
  CONCLUSIONS
  The measurement of conductivity of the skin as an objective tool to measure pain and discomfort during invasive procedures in neonatal intensive care shows that, despite the use of sedation and analgesia, neonates experience discomfort associated with the selected performance of therapeutic and diagnostic procedures.
authors.affiliation: Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland. hanna.misiolek@gmail.com.
authors.forename: Jacek
authors.initials: J
authors.lastname: Karpe
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Misiołek
authors.forename: Andrzej
authors.initials: A
authors.lastname: Daszkiewicz
authors.forename: Hanna
authors.initials: H
authors.lastname: Misiołek
mesh_terms: D000698:Analgesia / Q000379:methods; D001784:Blood Gas Analysis / Q000379:methods; D005712:Galvanic Skin Response / Q000502:physiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal / Q000379:methods; D007442:Intubation, Intratracheal / Q000379:methods*; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D010147:Pain Measurement; D012121:Respiration, Artificial / Q000379:methods*; D013312:Stress, Physiological / Q000502:physiology*; D013396:Suction
chemical_list: D006993:Hypnotics and Sedatives